一名偏头痛患者接种乙肝疫苗后出现单侧视乳头水肿。病例报告，包括法医学方面的内容。
Unilateral papilloedema after hepatitis B vaccination in a migraine patient. A case report including forensic aspects.
作者信息
Fledelius H C
机构信息
University Eye Department, Rigshospitalet, Copenhagen, Denmark.
出版信息
Acta Ophthalmol Scand. 1999 Dec;77(6):722-4. doi: 10.1034/j.1600-0420.1999.770626.x.
PURPOSE
To report on a unilateral optic nerve reaction appearing 9-10 hours after vaccination against hepatitis B.
METHODS
To describe the case and discuss the underlying mechanisms. There was a scintillating scotoma leaving a permanent inferior notch in the visual field, but central vision was left normal and with only a slight affection of colour perception. Shortly the optic nervehead appeared engorged, then slightly ischaemic, but was hardly left with evidence of atrophy.
RESULTS
Immune-based reactions could hardly be held responsible, multiple sclerosis was unlikely, and ultrasonography excluded optic nervehead drusen. An optic nerve migraine mechanism is probable, possibly with the vaccination having acted as the trigger.
目的
报告1例接种乙肝疫苗后9 - 10小时出现的单侧视神经反应。
方法
描述该病例并探讨潜在机制。存在闪烁暗点，视野中留下永久性下方切迹，但中心视力正常，仅色觉稍有影响。视神经乳头很快出现充血，随后稍有缺血，但几乎未留下萎缩迹象。
结果
基于免疫的反应不太可能是病因，多发性硬化症不太可能，超声检查排除了视神经乳头玻璃疣。视神经偏头痛机制很可能，疫苗接种可能起到了触发作用。
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